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Extraocular muscles

Topic: Anatomy

Created on Tuesday, July 11 2006 by

Last modified on Wednesday, December 31 1969.

A 68 year-old female wheat germ botanist visits you in your clinic, complaining of diplopia.
You note that most of the time that she is facing you and talking, she sits with her chin turned toward her left shoulder and her right eye adducted.
Based on this information alone, you suspect that there may be a paresis of which extraocular muscle?

A) Left lateral rectus

B) Right oblique rectus

C) Right inferior oblique

D) Left medial rectus

E) Left inferior oblique

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This question was created on July 11, 2006 by .
This question was last modified on December 31, 1969.

ANSWERS AND EXPLANATIONS

A) left lateral rectus

This answer is correct.

This presentation is typical of a paresis of the left lateral rectus. A patient with a paresis of the left lateral rectus muscle will have impaired adbuction of the left eye, and is likely to try to minimize her diplopia by looking at the world with her chin turned toward her left shoulder and her right eye adducted. (See References)


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B) right oblique rectus

This answer is incorrect.

This presentation is typical of a paresis of the left lateral rectus. The right oblique rectus is not a real muscle. (See References)


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C) right inferior oblique

This answer is incorrect.

This presentation is typical of a paresis of the left lateral rectus. Paresis of the right inferior oblique muscle does not present in this way. (See References)


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D) left medial rectus

This answer is incorrect.

This presentation is typical of a paresis of the left lateral rectus. A patient with a paresis of the left medial rectus muscle will have impaired adduction of the left eye, and is likely to try to minimize her diplopia by looking at the world with her chin turned toward her right shoulder and her right eye abducted. (See References)


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E) left inferior oblique

This answer is incorrect.

This presentation is typical of a paresis of the left lateral rectus. Paresis of the left inferior oblique muscle does not present in this way. (See References)


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References:

1. Ross, R.T. (1999). How to Examine the Nervous System, 3rd Edition. Appleton & Lange, Stamford, Connecticut. Pp. 45-60


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anatomy
Extraocular muscles
Question ID: 0000003
Question written by . (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 07/11/2006
Modified: 12/31/1969
Estimated Permutations: 0